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Posts Tagged ‘app’

Due to the current situation, Primary Care has been brought to the limits of its endurance. This cannot come as a surprise. Most systems are tailored to the current needs that the system has to attend to, not to emergency situations. The job of Primary Care is to attend the day-to-day business of the population, acting as the front door to the health system, and to monitor the evolution of chronic patients.

Covid-19 has added a new dimension to this job description: doing the triage of the population in view of identifying those infected with the virus. It would not be a big problem if that were a normal procedure: anamnesis, decision, and derivation to the appropriate health resource or, as is the case of the flu, a recurrent winter event that can be pre-programmed. But this is not the case. To start with, SARs-CoV-2 is a very infectious virus that occurs throughout the entire year. The fact that it is highly infectious has changed the way the healthcare professional has to confront his/her prospective patient. The professional has to be equipped with Personal Protective Equipment (PPE), the premises have to be disinfected regularly, incoming people have to be pre-checked to avoid unnecessary contagion of personnel and contamination of the premises. All of these procedures necessarily slow the flow of patients precisely when the flow increases due to the pandemic. The result is a bottleneck in the system, and in an attempt to solve it, monitoring of chronic patients is sent to the back of the Primary Care priorities. The system assumes that a chronic patient will not evolve so quickly as to need urgent intervention: just take your medication and hope for the best.

But there is a solution. There are plenty of simple ICT applications to monitor vital signs and other signs like glucose. Unfortunately, we must admit that the biggest barrier to its introduction has come from healthcare professionals. While it is assumed that if the patient needs a medication, the healthcare professional will administer/prescribe it, it is still exceedingly rare that the same professional will prescribe an app. There is no explanation for this dichotomy. How can you explain that a professional will not recommend/prescribe something that is good for the patient and for himself/herself? It saves work for the professional and empowers the patient, allowing the latter more control of the management of his/her condition. There is for sure a long way to go, but the first step in the journey is to convince health professionals of the usefulness of ICT apps, probably using the same procedure that pharmaceutical companies use to introduce their products.

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The current Covid-19 pandemic has made possible the explosion of telemedicine. Those more reticent to its use, healthcare professionals, have discovered that it is an efficient working tool.

At the same time, individuals have discovered that they have to take their health in their own hands. There has been a lot of talk in recent years about empowering the patient/individual. But only when the pandemic has hit us have we discovered that there are a lot of health apps that can help us to keep fit or control our ailments. The Quarterly Digital Health Trends Report has some amazing figures. Comparing pre-covid and post-covid Google searches, terms like healthy-eating or healthy-living have increased by 385% or 850% respectively.

It is easy to see how those two trends are related. Professionals feel that they have to be more efficient in the way they provide their services; teleconferencing is a very efficient way to deal with some consultations that do not require an in-presence meeting of patient and medic. At the same time, we individuals have come to the conclusion that we should not take advantage of the medical services by drowning them  with requests that could be solved if only we were aware of the implications of our behavior: basically eating, drinking and exercising.

Eating, drinking, and exercising, probably together with complying with medication medical orders, are the realm of apps. There has been a 22% year on year increase of downloads in health and fitness apps (The State of Health & Fitness Apps, SensorTower, 2020). The more we use these kinds of apps, the less the pressure on medics. I know there is a long way to go till health and social services realize that prescribing apps saves money to the system. We will have to go through a long period in which we will have to pay for those apps that will help us to keep fit and healthy. But what is sure is that the money will be well spent.

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Certainly we are living in interesting times. My first “serious” job was as Administrator of the Computing Centre at the Complutense University of Madrid. The centre was equipped with an IBM 360 which had a main memory smaller than my actual smart phone. So here we are, equipped with a powerful hand held instrument that, most of us, use for calling/texting friends and acquaintances, listening to music or watching TV shows. What a waste!

So, people around the world are trying to introduce us to the wonders of apps: smart little pieces of programming that are intended to make life easier for us. From advising us when the next bus is coming to how to navigate those streets we are not familiar with.

But there is another use that is being explored and promoted but still is not part of our lives. I am talking about those apps that are intended to change our lives. According to a recent report (mHealth App Economics 2017 http://www.research2guidance.com) there are some 350.000 health apps on the market. I have not found a similar study for other sectors, for example managing disasters, but a Google search for it gives 262 results, so it is not a fringe issue either.

Anyhow, the fact is that be it 350.000 or 262, the spread of those apps is meaningless. Do you know anybody in your circle using one app for a practical use in health or in security? I do not and I am closely involved with the socio-health sector, and have some connection with security issues.

The only possible conclusion is that the business model on which those apps rely are faulty. Most of them are built thinking of the future, a user that does not exist, either because the app is too complicated or because it is too simple. We are simply forgetting about user-centered co-design. We design things for the user but not with the user. Let´s try in 2018 to change our design mainframe and put the user in the centre of our efforts. That will make our times even more interesting.

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Millions of people use smartphones with a processing capacity that not many years ago was reserved for big mainframes. Not as many millions, but certainly a good number, design apps intended for helping people’s lives; and many of them are e-health related. So, how can the e-health app designer make a mark on those millions of people and differentiate his or her product from the competition?

The designer needs to generate not only the first click, but needs to make that click a habit for the user. Put this way, clearly we have two problems to solve.

Problem one is to induce a lot of people to make that first click that will make our app known to the user. How does a theme become a buzz in the www? We need to create some kind of social movement that makes our app something people talk about, something “cool people” have to know about. You need somebody who can turn an idea into a buzz.

Problem two is to make that first click a habit. A habit is something that becomes part of a person’s life. How do you promote habits into the population? Well, the tobacco industry knows a lot about it and I am not talking about drug addictions, I am talking about the glamour that is still associated with smoking: the Habano cigar in hand transmits something very appealing to a lot of people. We have to be bold in our need to change people’s behavior. So when designing our app we have to imbed into it the addiction factor. Call it serious games or gamification, but to be successful you will need expertise in this area to help you.

Your app efficacy is beyond any doubt; you are the best app designer because you have identified a problem and knew how to solve it. But if you are lacking in social abilities to make a dent in the www, and behavioral change is a concept alien to you, well, I’m sorry to tell you that you will not succeed in the market place.

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